摘要
４８例肺癌胞转移瘤放疗后总的症状缓解率为８７．５％。全脑照射２０一３０Ｇｙ（Ａ组）、３１～４０６ｙ（Ｂ组）以及３１～４０６ｙ＋缩野补充照射２０一３０Ｇｙ（Ｃ组）的症状缓解率分别为９０．０％、９２．９％和９７．６％，三组间差异无统计学意（Ｘ２＝１．９６ｐ＝０．３７５６）。Ａ、Ｂ、Ｃ三组的症状完全缓解率分别为４７．５％、７８．６％和８０．５％，Ａ组与Ｂ组、Ａ组与Ｃ组之间差异有统计学意义；Ｂ组与Ｃ组之间差异无统计学意义。建议对于全身情况差、估计生存期短的病人，全脑照射时采用较低剂量短疗程的放射治疗方案，如２０一３０Ｇｙ／１一２周或２０一３０Ｇｙ／２一３周；全身情况较好，无颅外远处转移的单个脑转移灶、宜用高剂量放射方案，对于不能手术的单个脑转移灶，尽可能局部追加照射至５０～６０Ｇｙ，能手术者，应尽早手术，术后常规全脑照射３１一４０Ｇｙ／３一４周。
FOrty-eight cases of
brain metastases from lung cancer were stu-died restrospectively for
the effectiveness of cranial radiotherapy. The overall response rate
of neurologic symptoms was 87.5% at 4 weeks from starting cranial
radiotherapy.The overall response rates were 90.0% for patients
received wholebrain radiation therapy (WBRT) to a dose of 20─
30Gy(Group A), 92.9% for patients received WBRT to a dose of 3l─40
Gy(Group B), and 97.6% for patients received WBRT to a dose of 3l─
40Gy followed by a localized boost(Group C), respectively.These
overall response rates are not statistically
different(X2=1.96,p=0.3756).The complete response rates for group A,
B,and C were 47.5%,78.6%, and 80.5 % respectively.There was
significant difference in complete response rate between Group A and
Group B(X2=6.64,p=0.0l) or Group A and Group C
(X2=9.59,p=0.002).There was no significant difference in complete
response rate between Group B and Group C(X2=0.04.p=0.8459).The
authors suggestthat the patients with an estimated short-term
survival,short courses of radiation of 20─3OGy/1─2weeks or 20─
30Gy/2─3 weeks could be considered and the patients with an
estimated long-term survival or even cure, more prolonged courses of
radiation of 3O─ 40Gy/3─4weeks could be consider.If the metastases
is solitary, the patient is not a surgical candidate,then WBRT to a
dose of 31─40 Gy/3─4 weeks followed by a boost dose of radiation of
20─30 Gy is indicated.If the metastases is a single surgical
acces-sible lesion,the patient has a good performance status,surgical
resection is indicated.Postoperative WBRT should be routinely
administered by standard fractionation schemes of l.8 to 2 Gy/day to
a total doses 31 to 40 Gy.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
1995年第2期120-123,共4页
Chinese Journal of Cancer
关键词
肺肿瘤
脑转移瘤
放射疗法
Lung cancer Brain metastasis
Radiotherapy
